研究CT血管成像（CTA）对肠系膜下动脉分型评估及腹腔镜直肠癌手术的指导价值。

回顾性分析2021年12月至2024年1月195例行腹腔镜直肠癌根治术的患者临床资料，行CTA检查的为观察组（n=107），行常规CT检查的为对照组（n=88）。SPSS软件22.0分析数据，数据以（±s）、[M(IQR）]或[例（%）]表示，采用t检验、非参数秩和检验、χ²检验或Fisher精确概率法。P<0.05表示差异有统计学意义。

观察组患者手术时间、术中出血量、住院时间、首次下床时间明显优于对照组，均Cohen’s |d|>0.8，差异具有统计学意义（P<0.05）；观察组患者术后并发症总发生率低于对照组，差异具有统计学意义（P<0.05）。观察组患者术中肠系膜血管及其分支情况与术前多层螺旋CT血管成像（MSCTA）检查结果符合率显著高于对照组（100% vs. 90.9%, P<0.05）。观察组Ⅰ-Ⅲ血管分型的患者手术时间与术中出血量均低于对照组，差异具有统计学意义（P<0.05）。

直肠癌根治术前施行CTA技术，辅助术者高效规划手术，显著缩短手术时间；助力术前明晰血管分布，术中精准操作以减少出血量；优化手术方案，降低术后并发症发生率，有力促进患者术后康复。

To study the value of computed tomography angiography (CTA) in evaluating the classification of the inferior mesenteric artery (IMA) and guiding laparoscopic rectal cancer surgery.

The clinical data of 195 patients with rectal cancer who underwent laparoscopic radical resection of rectal cancer from December 2021 to January 2024 were analyzed retrospectively. The patients were divided into two groups according to the examination method: Observation Group: 107 patients who underwent CTA examination; Control Group: 88 patients who underwent conventional CT examination. Data were analyzed using SPSS 22.0 software. Data were expressed as (±s), [M(IQR)] (median and interquartile range), or [cases (%)] (number of cases and percentage). Statistical tests including t test, nonparametric Rank-Sum test, χ² test, or Fisher’s exact test were used as appropriate. P<0.05 was considered statistically significant.

The operation time, intraoperative blood loss, length of hospital stay, and time to first ambulation after surgery in the Observation Group were significantly better than those in the Control Group, with Cohen’s |d|>0.8 for all indicators, and the differences were statistically significant (all P<0.05). The total incidence of postoperative complications in the Observation Group was lower than that in the Control Group, with a statistically significant difference (P<0.05). The coincidence rate between the intraoperative findings of mesenteric blood vessels and their branches and the preoperative multi-slice spiral computed tomography angiography (MSCTA) results in the Observation Group was significantly higher than that in the Control Group (100% vs. 90.9%, P<0.05). Among patients with IMA classification of Type Ⅰ–Ⅲ, the operation time and intraoperative blood loss in the Observation Group were lower than those in the Control Group, and the differences were statistically significant (all P<0.05).

Performing CTA before radical resection of rectal cancer can assist surgeons in efficiently planning the operation and significantly shortening the operation time; it helps clarify the vascular distribution preoperatively and enables precise intraoperative operation to reduce blood loss; it optimizes the surgical plan, reduces the incidence of postoperative complications, and strongly promotes the postoperative recovery of patients.